Kimberly Curry, Seeds of Hope Foundation executive director, stands with construction workers on the second floor of 622 Yonge St., where a new Lazarus House is currently under construction.Photo by Michael Swan

Toronto's new Lazarus House gives hope to schizophrenic women

TORONTO - The mentally ill occupy the streets of Toronto. They sleep there. They beg. They buy drugs. They rave, cry out in pain and frighten people. They pass through drop-ins, shelters, jails and the emergency wards but somehow almost always wind up back on the same little patch of urban territory.

Seeds of Hope Foundation executive director Kimberly Curry thought there must be something we can do for homeless, schizophrenic women. Sr. Susan Moran, co-founder of Out of the Cold program almost 25 years ago, had the same thought. She never thought giving people a mattress in a church basement one night a week fulfilled our Christian duty.

Moran’s first attempt, almost 15 years ago, was called Mary’s Home. It started as an Out of the Cold program but never evolved into a supportive home for the chronically homeless. In the end it became an important emergency shelter for women in downtown Toronto.

That was followed by the first Lazarus House, which eventually welcomed refugees.

With the backing of Seeds of Hope Foundation — which serves the marginalized through 6 St. Joseph House, the Alano Club, Our Homes and the Yellow Door Learning Centre — Moran’s dream is finally becoming a reality.

A new Lazarus House is under construction upstairs at 622 Yonge St., just around the corner from 6 St. Joseph House. This time it will house the homeless — up to 10 women in a demonstration project that takes a housing-first approach. The idea is to give people the dignity and security of a room of their own before attempting to deal with their medical and psychiatric troubles. Because going at the problem on a treatment-first basis isn’t working, said Curry. She’s seen schizophrenic patients enter hospitals but then refuse treatment. She’s also seen hospitals turn them back out onto the street after just one or two days.

“We worked with three different women. We would take them to the hospital and started to see the gaps in the system, where they would get kicked out” said Curry. “I couldn’t believe that someone so mentally ill, and it was so obvious, but the hospitals didn’t want to deal with them.”

There are a lot of factors that conspire against delivering psychiatric care to homeless paranoid schizophrenics, said St. Michael’s Hospital psychiatrist in chief Dr. Vicky Stergiopoulos.

“There are some people where the illness itself leads them to disengage from treatment. They don’t want care,” she said.

Both Ontario law and basic medical ethics prevent doctors from treating people against their will. But as important as it is to respect the wishes of patients, it raises dilemmas when it comes to severe mental illness.

“People can make really bad decisions — decisions that are not based on any capacity to make decisions. And yet we have valued autonomy above everything else, and for some it has led to bad outcomes,” said Stergiopoulos.

After years of running street outreach programs based at St. Michael’s and her scientific research into homelessness and mental health, Stergiopoulos backs the housing-first approach.

“We’re not saying people need to accept treatment. We provide them support and housing. They don’t have to agree to see a physician. They don’t need to agree to take medication. They don’t need to agree to stop using drugs,” she said. “There is wide recognition that this is a way to provide care to people.”

To that formula, Curry adds friendship. She and the volunteers at 6 St. Joseph House determinedly offer and re-offer friendship to some very difficult people.

“Because trust was gained over time, they did start to want to get help. They did regain some dignity. They did start doing things on their own,” said Curry, who has spent most of her working life in architecture and marketing.

Curry is basing plans for Lazarus House on her experience with three of her homeless friends.

“One of these women ended up staying at CAMH (Centre for Addiction and Mental Health) for three months and another for four,” she said. “And when they did get the help and on the right medication, they’re fully functional and beautiful human beings. They can live a life. It’s just a long process to get there.”

No doctor can prescribe friendship — or housing. But those are the critical links between the street and the capabilities of medical science, said Curry.

“It’s sick that we can let people live like this and have all the resources out there but just not help,” she said. “This is where I see a community, a Christian community and Christian compassion, coming into play at all levels.”

So far, Seeds of Hope has the money for extensive renovations to the premises and a 10-year lease on the Lazarus House property. Money to run the program is still a challenge.

Scientifically speaking, the Lazarus House approach is worth the investment, said Stergiopoulos.

“I’ve worked in shelters and the streets. I’ve led research with the At Home project. Most of our clients have schizophrenia. We’ve managed to help the vast majority,” she said.